Razi Journal of Medical Sciences
مجله علوم پزشکی رازی
RJMS
Medical Sciences
http://rjms.iums.ac.ir
39
journal39
2228-7043
2228-7051
en
jalali
1392
7
1
gregorian
2013
10
1
20
112
online
1
fulltext
fa
تأثیر مواجهه با نویز بر سیستم شنوایی کارگران با استفاده از ادیومتری تون خالص (PTA)، گسیلهای صوتی گذرای گوش (TEOAEs) و گسیلهای صوتی محصول اعوجاج (DPOAE)
Effect of noise exposure on auditory system of industrial workers using pure tone audiometry (PTA), transient evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs)
گوش و حلق و بینی
ENT
پژوهشي
Research
<font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal unicode-bidi: embed direction: rtl text-justify: kashida text-kashida: 0% mso-pagination: none" dir="rtl"><b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">زمینه
و هدف</span></b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">: نتایج مطالعات مختلف نشان می دهد که سلولهای مویی خارجی
مسئول تولید گسیل های صوتی گوش </span><span dir="ltr"></span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr"><span dir="ltr"></span>(OAE)</span><span dir="rtl"></span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> در پاسخ به تحریکات صوتی می باشند و اولین ساختاری هستند که توسط
نویز با شدت بالا دچار آسیب می شوند. هدف از تحقیق حاضر بررسی پاسخ های ادیومتری
تون خالص، دامنه گسیل های صوتی گذرای گوش </span><span dir="ltr"></span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr"><span dir="ltr"></span>(TEOAE)</span><span dir="rtl"></span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> و گسیل های صوتی محصول اعوجاج </span><span dir="ltr"></span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr"><span dir="ltr"></span>(DPOAE)</span><span dir="rtl"></span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> در کارگران در معرض نویز غیرمجاز در مقایسه با کارمندان بخش اداری
بود.<o:p /></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal unicode-bidi: embed direction: rtl text-justify: kashida text-kashida: 0% mso-pagination: none" dir="rtl"><b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">روش
کار</span></b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">: مطالعه به صورت مورد-شاهد انجام گرفت. گروه های مورد مطالعه متشکل
از 89 کارمند اداری (شاهد) و 134 کارگر در معرض نویز غیر مجاز بود. آستانه های
ادیومتری، </span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr">TEOAE</span><span dir="rtl"></span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> و </span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr">DPOAE</span><span dir="rtl"></span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> در همه افراد مورد ارزیابی و تحلیل قرار گرفت.</span><span lang="FA" style="font-family: "B Mitra" mso-bidi-language: FA mso-ascii-font-family: Calibri mso-hansi-font-family: Calibri"><o:p /></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal unicode-bidi: embed direction: rtl text-justify: kashida text-kashida: 0% mso-pagination: none" dir="rtl"><b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">یافتهها:</span></b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 13pt mso-bidi-language: FA"> </span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">میانگین آستانههای شنوایی در فرکانس های 1 الی 4 کیلوهرتز
برای گروه مورد بالاتر از گروه شاهد بود</span><span dir="ltr"></span><span lang="AR-SA" style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr"><span dir="ltr"></span>
</span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">و این تفاوت در فرکانس های 3 و 4 کیلوهرتز از نظر آماری معنی
دار بود (01/0></span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr">p</span><span dir="rtl"></span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt"><span dir="rtl"></span>). درصد بیشتری از کارگران گروه مورد
دارای عدم </span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr">TE</span><span dir="rtl"></span><span style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> <span lang="AR-SA"><font face="B Mitra" size="2">و </font></span></span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr">DP</span><span dir="rtl"></span><span style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> <span lang="AR-SA"><font face="B Mitra" size="2">بودند. همچنین دامنه های</font></span></span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr">TEOAE</span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">در هر چهار فرکانس1
الی 4 کیلوهرتز در گروه مورد کاهش معنی داری را نشان داد (01/0></span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr">p</span><span dir="rtl"></span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt"><span dir="rtl"></span>). دامنه های </span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr">DPOAE</span><span dir="rtl"></span><span style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> <span lang="AR-SA"><font face="B Mitra" size="2">در گروه مورد از نظر آماری کاهش قابل توجهی را در 4/4 کیلو هرتز نشان داد
(001/0></font></span></span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr">p</span><span dir="rtl"></span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt"><span dir="rtl"></span>).</span><span lang="FA" style="font-family: "B Mitra" font-size: 12pt mso-bidi-language: FA mso-ascii-font-family: Calibri mso-hansi-font-family: Calibri"><o:p /></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal unicode-bidi: embed direction: rtl text-justify: kashida text-kashida: 0% mso-pagination: none" dir="rtl"><b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">نتیجه</span></b><b><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-size: 10.0pt" dir="ltr"></span></b><b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">گیری</span></b><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt">:
کاهش بارز دامنه های </span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr">OAE</span><span dir="rtl"></span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> و افزایش آستانه های ادیومتری کارگران
در معرض نویز می تواند نشان دهنده آسیب حلزون شنوایی این افراد باشد. در این
مطالعه حساسیت فرکانسی </span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr">DPOAE</span><span dir="rtl"></span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> بالاتر از </span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr">TEOAE</span><span dir="rtl"></span><span lang="AR-SA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> بود و همخوانی بیشتری با نتایج ادیومتری داشت.</span><span lang="FA" style="color: black font-family: "B Mitra" font-size: 13pt mso-bidi-language: FA mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman""><o:p /></span></p><font face="Times New Roman" size="3"> </font>
<font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal text-justify: inter-ideograph"><b><span style="font-family: "Times New Roman","serif" font-size: 12pt mso-bidi-language: FA">Background: </span></b><span style="font-family: "Times New Roman","serif" font-size: 12pt">Different
studies have shown that Otoacoustic Emission (OAEs) is generated by Outer Hair
Cells (OHCs) and these sensory cells are first structures exposed to damage of
high level noise. Therefore minor impairment in OHCs can lead to lack of
response of OAE. The purpose of the current study is to compare the pure tone
thresholds, Transient Evoked Otoacoustic Emission (TEOAE) and Distortion
Product Otoacoustic Emission (DPOAE) amplitude in industrial workers
experiencing non-permissible noises and official staffs.</span><span style="font-size: 13pt mso-bidi-font-family: "B Mitra""><o:p /></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal text-justify: inter-ideograph tab-stops: right 7.3pt center 265.9pt"><b><span style="font-family: "Times New Roman","serif" font-size: 12pt">Methods</span></b><span style="font-family: "Times New Roman","serif" font-size: 12pt">: This study was
conducted as a case control paradigm. The cases included 134 workers exposed to
non-permissible noise and control group that constituted 89 official staff. The
threshold of pure tone, TEOAE and DPOAE amplitudes were recorded and compared
among the subjects.<span lang="AR-SA" dir="rtl"><o:p /></span></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal text-justify: inter-ideograph tab-stops: right 7.3pt center 265.9pt"><b><span style="font-family: "Times New Roman","serif" font-size: 12pt">Results:</span></b><span style="font-size: 12pt mso-bidi-font-family: "B Mitra" mso-ascii-font-family: Calibri mso-hansi-font-family: Calibri"><font face="Calibri"> </font></span><span style="font-family: "Times New Roman","serif" font-size: 12pt">Pure tone thresholds at frequencies of
1- 4 KHz among industrial workers</span><span style="color: black font-family: "Times New Roman","serif" font-size: 13pt mso-bidi-language: FA mso-bidi-font-family: "B Mitra""> </span><span style="font-family: "Times New Roman","serif" font-size: 12pt">were higher (worse) than the control
group and these differences were significant within frequencies of 3 and 4 KHz
(p< 0.01). TEOAE amplitudes within 4 frequencies (1-4 KHz) indicated significant
decrease among workers group in comparison with control group (p<0.05).
Although DPOAE amplitudes indicated decrease within 4 frequencies in the
workers group, these differences were statistically significant only in 4.4 KHz
(<a name="_GoBack"></a>p< 0.01).<o:p /></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal text-justify: inter-ideograph tab-stops: right 7.3pt center 265.9pt"><b><span style="font-family: "Times New Roman","serif" font-size: 12pt">Conclusions: </span></b><span style="font-family: "Times New Roman","serif" font-size: 12pt">The decrease of
OAE amplitudes and increase in audiometric thresholds in workers may indicate
damage to cochlea due to noise exposure. In the current study, the sensitivity
and specificity of DPOAE frequency responses was estimated higher than the
TEOAE. It seems that DPOAE responses may have been more homogeneic to
audiometric results.<span lang="AR-SA" dir="rtl"><o:p /></span></span></p><font face="Times New Roman" size="3"> </font>
آسیب شنوایی ناشی از نویز، گسیل های صوتی برانگیخته گذرای گوش، گسیل های صوتی محصول اعوجاج، ادیومتری تون خالص.
Noise-induced hearing loss, Transient evoked otoacoustic emission, Distortion product otoacoustic emission, Pure tone audiometry, Noise pollution.
84
92
http://rjms.iums.ac.ir/browse.php?a_code=A-10-1-1462&slc_lang=fa&sid=1
Mohammad
Farhadi
محمد
فرهادی
3900319475328460024220
3900319475328460024220
No
Iran University of Medical Sciences
دانشگاه علوم پزشکی ایران
Saeid
Mahmoudian
سعید
محمودیان
3900319475328460024221
3900319475328460024221
No
Iran University of Medical Sciences
دانشگاه علوم پزشکی ایران
Azardokht
Tabatabaei
آذردخت
طباطبایی
3900319475328460024222
3900319475328460024222
Yes
Iran University of Medical Sciences
دانشگاه علوم پزشکی ایران
Ahmad
Naghavi
احمد
نقوی
3900319475328460024223
3900319475328460024223
No
Shahid Haydari Policlionic
پلی کلینیک شهید حیدری، تهران
Morteza
Hamidi Tehrani
مرتضی
حمیدی تهرانی
3900319475328460024224
3900319475328460024224
No
Iran University of Medical Sciences
دانشگاه علوم پزشکی ایران
Shima
Javadinia
شیما
جوادنیا
3900319475328460024225
3900319475328460024225
No
Iran University of Medical Sciences
دانشگاه علوم پزشکی ایران